an autodidact meets a dilettante…

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Posts Tagged ‘autophony

exploring clogged ears

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Canto:  So we were going to have another go at Bayesian probability and reasoning. Even though I think I already understand it from last time…

Jacinta: Well actually the piece I wrote on this blog in August 2019 does a pretty good job of explaining it, but we easily forget…

Canto: So onto more pressing matters. I’ve developed a big hearing problem, as a result of a bacterial infection which cleared up soon enough with the help of antibiotics. These infections are a regular problem for me, as I have a chronic condition, bronchiectasis, which means my upper airways have a high bacterial load, and so I’m quite convinced that antibiotics have been a life-saver for me. But this time one of the symptoms was a blockage of some kind in my left ear, which appears to be behind the ear-drum. My regular doctor and an audiologist could find nothing visible – no build-up of wax for example. My doctor wrote something about glue ear, with a question mark, to the audiologist – so I need to research this condition. And there’s also a problem with my right ear – a perforated ear-drum, and quite a large one according to the audiologist. So the right ear problem has clearly been with me for a long time – I knew my hearing wasn’t the best – and is perhaps getting worse, but the sudden blockage to my left ear has caused something of a crisis. Just at the time this infection occurred I was asked to return to work at Eynesbury College, but I had to refuse, as my hearing was so bad. All of this happened in November, but I won’t be seeing the Otolaryngologist (a new term to me) until February 21st which is vraiment frustrant. 

Jacinta: So we’re going to have a look at glue ear, common childhood complaint, and similar issues. By the way, otolaryngology is a shortened form of the term otorhinolaryngology (ear-nose-throatology), of course, and it’s the oto (Greek for ear) that we’re concerned about here:

Glue ear is caused by blockage of a small tube in the ear, called the Eustachian tube. When fluid is trapped inside this tube, fluid builds up in the middle ear cavity (called an effusion) and this can slowly get thicker. This often happens after a head cold. Glue ear can happen after repeated middle ear infections.

Canto: This sounds just like my problem, and I was worried precisely about this thickening, which is what I feel is happening, and I fully expect that, like glue, it’ll be much tougher to remove when it hardens. So why must I wait? Anyway, the blockage is the immediate problem, it makes my voice sound loudly in my ear, and if I’m eating something crunchy, the sound is like ice crashing down from Antarctic cliffs. When I’m talking one-on-one with someone I try to arrange it so they’re talking into my right ear, the one with the perforation.

Jacinta: Mmmm, well let’s learn more about the inner ear, the Eustachian tube and such. Glue ear is most often associated with children, but some one in three sufferers are adults. There are a variety of causes, and symptoms – it’s sometimes just referred to as a clogged ear. I can’t find much reference to your symptom of having an amplified voice….

Canto: I’m told sometimes to speak up, because apparently I’m lowering my voice because it sounds so loud in my head.

Jacinta: Yes, well here’s something:

Autophony is the unusually loud hearing of a person’s own voice. Possible causes are: The “occlusion effect”, caused by an object, such as an unvented hearing aid or a plug of ear wax, blocking the ear canal and reflecting sound vibration back towards the eardrum.

Canto: Autophony. Eureka! But none of those causes fit my situation.

Jacinta: Well, here’s something from another website that’ll be more helpful:

Autophony is the perception that your voice is too loud or echoing in your ears. Autophony also refers to the perception of all other sounds coming from your body, such as breathing or arterial noises. Typically, autophony results from a middle ear infection, such as tuba beante. Other causes may include eardrum occlusions, serous otitis media, open or patulous Eustachian tube, or Minor’s Syndrome.

Canto: Yes, that gives me plenty of material for research. So, first, a two-part YouTube piece taken from the over-slick US show The Doctors features someone who seems to have my problem intermittently, and worries whether she’ll be able to ‘go on’ if it becomes permanent like mine has – at least temporarily. She was finally diagnosed with patulous Eustachian tube dysfunction (I suspect this is not my problem though). Their resident otolaryngologist explains that the Eustachian tube starts at the back of the nasal cavity – though I tend to think of it from the other end, in the middle ear starting from behind the tympanum…

Jacinta: Patulous in the medical sense means wide open or distended. I’m not quite sure if I can picture this, does it mean that this airway – and it is an airway if you think of it as coming in through the nasal cavity – is distended just as your bronchial airways are distended due to your bronchiectasis?

Canto: Well, that’s a thought. Could it be an extension of my bronchiectasis? And not a problem of fluids at all? The otolaryngologist explained that this client’s Eustachian tube is ‘in open position more than normal, so all those sounds – chewing, breathing, etc, is going right into [her] Eustachian tube and is being transmitted in turn to the middle ear space’. So if this is my problem – another development of my bronchiectasis…

Jacinta: Don’t mean to scare you but bronchiectasis is described as a condition that can tend to worsen over time….

Canto: Yeah thanks. Our TV otolaryngologist describes helpful treatments that might close down this airway – drops (sounds unlikely) – oestrogen drops through the nose, and other preparations, or surgery to manipulate the opening, ‘injecting something to try to close it down’, all of which sounds eminently vague.

Jacinta: If it is fluid, and it’s thickening, I’m sure they have some means of thinning it down…

Canto: Well I’ve heard from someone – yes, a doctor friend – that they have a procedure which punctures or perforates the eardrum, drains the fluid (I’m not sure in my case) and then leaves a little plug to keep the drum open, but just a wee bitty.

Jacinta: Okay, on it…:

  • Grommets are tiny ventilation tubes that are put inside the eardrum to prevent a build-up of fluid.
  • They are needed if someone has a lot of ear infections that have caused ‘glue ear’.
  • A person will need to go to a hospital to have grommets put in. They need minor surgery under general anaesthetic.
  • Grommets usually fall out by themselves after 6 to 12 months.

Canto: Yeah that sounds like it. So we’ve dealt long enough with the left ear, how about the right one?

Jacinta: A large perforation, you say? Here’s the Mayo Clinic:

A hole in the tissue that separates the ear canal from the middle ear.
A perforated eardrum may be caused by loud sounds, a foreign object in the ear, head trauma, a middle ear infection or rapid pressure changes, such as from air travel.
Symptoms include sharp ear pain that subsides quickly, drainage, ringing in the ear (tinnitus) or hearing loss.
The condition usually heals on its own within a few weeks. Antibiotics, an eardrum patch or surgery may be necessary.
Canto: My doctor mentioned a surgery involving skin grafts, but they aren’t always successful, they don’t ‘take’. Also I’ve never had sharp ear pain. Occasional non-painful tinnitus, that’s all. And I don’t think there’s ever been any head trauma or foreign objects… But ultimately I’d like to have both ears fixed if possible. I may have to lose an arm and a leg to do it though….
Jacinta: To be continued…

References

https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

https://www.healthline.com/health/why-does-my-ear-feel-clogged#tube-blockage

https://www.amplifon.com/uk/ear-diseases-and-disorders/other-hearing-problems/autophony

https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/bronchiectasis.html

https://www.healthdirect.gov.au/grommets

https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879

https://www.emedihealth.com/ent/ear/clogged-ears-causes

Written by stewart henderson

January 16, 2023 at 8:11 pm